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GreenField’s Health Matters: September, 2005
New Weight Management Program
We are pleased to announce a new program available to GreenField patients called "Transformation: The GreenField Health Weight and Lifestyle Management Program." In an effort to help our patients for whom weight has become a physical, medical and/or emotional burden, Dr. Cynthia Ferrier and the GreenField Health team have partnered with Ronda Gates, MS, a well-known health educator who has developed successful health promotion programs nationwide We have developed this program to help participants to learn skills and strategies to regain a healthy lifestyle and appropriate weight loss with fewer health consequences.
The introductory Transformation session will consist of a weekend intensive September 23rd and 24th followed by six in-depth weekly 2.5 hour sessions. Content will include physical evaluation, health assessments, diet and fitness instruction, menu planning, shopping education and discussion of the emotional aspect of our diet and exercise habits. This will be followed by 16 weeks of weekly check-ins with the GreenField team, evaluation of progress and reassessment of one's individual personal program. The second half of the program will also include monthly meetings of the group to discuss specific health or exercise topics in more detail. In addition to the instruction and evaluation, participants will also receive more than $200 worth of exercise equipment and tools to support weight management.
The first round of this 6 month program is now full, as class sizes are limited. We have developed a waiting list for the second program, which will start in January 2006. Please call us if you have any questions. Dr. Ferrier would be happy to discuss the program with you.
Understanding Your Lab Tests
As you know, we try hard to deliver laboratory results to our patients in a timely manner. We want to get the specific results directly to you, along with our interpretation of those tests. The most common blood tests are the metabolic panel, complete blood count, thyroid function tests, and lipid (cholesterol) panel.
We have discussed the interpretation of each of these tests in various prior Health Matters. In this issue, we compile the information for your reference. We want you to know as much about your health care as possible, so we provide this information to assist you in understanding your lab results. Our intent is only to give you insights into the tests, what the abbreviations stand for, and what it means to you as a patient.
When reporting lab tests, the laboratory typically provides the name of the test followed by the lab value, followed by a reference range that represents "normal" values that are in brackets. These tests are routinely ordered and performed as panels with anywhere from 2-20 values. For any one panel, it is not unusual to see one value that is slightly out of the normal range. Unless we notify you, this is not generally cause for concern.
We suggest that you save this issue of Health Matters electronically or print it out and keep it for future reference. If you'd like additional information on any particular test, please go to www.labtestsonline.org .
The Metabolic Panel
The basic metabolic panel includes blood chemistries (electrolytes and acid/base balance), blood sugar, and tests of kidney function. A comprehensive metabolic panel also includes liver function tests, blood proteins, and calcium.
Below is a list of the individual test components that you may see on one of these metabolic panels with frequent abbreviations noted in parentheses and a short explanation of the test. We do not have the space here to go into detail about how each of these tests are used or interpreted. Interpretation is dependent upon the clinical situation and many other factors. In general, we will interpret the test for you at the time we provide you with the results, but if you ever have any questions, please let us know.
Electrolytes
- Sodium (Na): the main "salt" in the body is sodium chloride and it is used to regulate blood volume
- Potassium (K): critical to muscle and nerve functioning
- Carbon Dioxide or Bicarbonate (CO2): used for acid-base balance in the body
- Chloride (Cl): the main "salt" in the body is sodium chloride and it is used to regulate blood volume
Kidney Function Tests
- Blood Urea Nitrogen (BUN): used as a crude measure of kidney function and to determine if an individual is dehydrated
- Creatinine (Cr): used to monitor kidney function
The Complete Blood Count (CBC)
The Complete Blood Count (CBC) is used to analyze your blood cells -your white blood cells (WBCs) which fight infections, your red blood cells (RBCs) which carry oxygen in your blood, and your platelets which are involved in blood clotting.
When is it ordered? A CBC is usually used to determine if you have anemia, to judge the severity of blood loss, to help diagnose infection, to help diagnose diseases such as leukemia, sickle cell disease or malaria, and to investigate a history of abnormal bleeding or clotting. As we discussed in our last Health Matters, these tests are frequently ordered as a matter of routine for screening purposes, although their usefulness in this regard is questionable.
- White blood cell (WBC) count is a count of the actual number of white blood cells per volume of blood. White blood cells are generally reported as thousands of WBCs in a microliter of blood - for example 5,000/µL. The WBC can be high due to infection or low due to certain bone marrow diseases.
- White blood cell differential looks at the types of white blood cells present. There are five different types of white blood cells, each with its own function in protecting us from infection. The types include: neutrophils, lymphocytes, monocytes, eosinophils, and basophils. The CBC typically measures these as a percentage of the total WBC's. Thus, the WBC differential is the percentage of WBC's that are of each type. Different conditions can cause an increase or decrease in total WBC's, or an increase in one type of WBC.
- Red blood cell (RBC) count is a count of the actual number of red blood cells per volume of blood. RBC's are reported as millions in a microliter of blood - 4,250,000/µL or 4.25x10 6 /µL. This test is most commonly used to check for anemia.
- Hemoglobin (HGB) measures the amount of oxygen-carrying protein in the blood. It is also used to check for anemia.
Flu Shots Available in October
We are pleased to announce that we have the flu vaccine available this year. We have already received some of our order, and will begin giving shots within the next few weeks. The best time to be vaccinated against the flu continues to be October and November, but vaccination in December or later can still be beneficial. Although anyone who wishes to avoid influenza should be vaccinated, those at highest risk for complications from influenza include people 65 years old and older, and those with chronic, long-term health problems such as heart or lung disease, kidney problems, diabetes, asthma, anemia, HIV/AIDS or any other illness that suppresses the
immune system.
In addition, healthcare workers and others in close contact with those at high risk should be vaccinated in order to reduce the possibility of transmitting influenza to those at high risk.
Logistically, this will work just as has in the past - you can come in at any time beginning October 3rd. We will promise no lines, good coffee, and relatively painless shots. We are happy to attempt to bill your insurance for this service, although in years past, we have not received many payments as this is usually not a covered benefit. If your insurance has paid for this in years past, we will send the bill to them. If your insurance carrier has not paid in years past, we will let you know before you get your shot that the cost will be out of pocket for you. The cost will be $30 per shot. If your insurance does pay for this, we will ask you to cover the co-pay amount, as this is a significant portion of the total cost.
As always, if you receive your flu shot elsewhere, please drop us a quick line to let us know. We track this as a part of our overall quality program, and it helps to keep us from nagging you (and we will if you fall into the high risk category) if we know that you've gotten it from another provider.
With our best wishes for a happy autumn, and a happy Back-to-School for many. As always, we thank you for the confidence you place in us to assist with your healthcare needs.
Sincerely,
Your GreenField Health Team:
Beth Davis, your Benefits Coordinator and Biller (email)
Chuck Kilo, MD (email)
Cynthia Ferrier, MD (email)
Dia Gaede, CMA, your Health Coordinator (email)
Elizabeth Hays, MD (email)
Eric Murray, MD (email)
Jill Arena, your Clinic Administrator (email)
Joel Swartzmiller, IT Manager (email)
Pam Mockenhaupt, CMA, your Health Coordinator (email)
Paula Koeller, MD (email)
Shelly Banta, your Clinic Manager (email)
Tiana Schmitt, MA, your Health Coordinator (email)
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GreenField Health System
9427 SW Barnes Road, Suite 590
Portland, OR 97225
Phone: 503.292.9560
Fax: 503.292.9510
Web: http://www.greenfieldhealth.com
questions, concerns, comments appreciated:
questions@greenfieldhealth.com
© 2003-2005 GreenField Health
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